Organization
MAGIC LAND DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS EDITH SUSANA MELGAR D.A. (ASSISTANT)
(213) 841-9302
Entity
Organization
Contact information
Practice address
3820 SEPULVEDA BLVD, TORRANCE, CA 90505-2408
(310) 792-5200
Mailing address
3849 W 111TH PL, INGLEWOOD, CA 90303-2619
(213) 841-9302
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4490656
CA
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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